Tuesday, 6 September 2011

Nutritional therapy in diabetes - does it change anything?

You would think that those people with diabetes in Europe would have undergone nutritional education and therefore have different diets to their non-diabetic fellows. Not so but there are a few small differences. People with diabetes tend to drink more soft drinks but less juice, wine and beer (and sweets). People with diabetes tend to eat a little more vegetables, fish and meat. Otherwise researchers who looked at the populations in the European Prospective Investigation into Cancer and Nutrition Study (EPIC) and the Multiethnic Cohort Study (MEC) found "only small differences in dietary behavior in comparison with cohort members without diabetes". [1]

Changing dietary habits is hard work. Does this mean that nutritional therapy in diabetes doesn't take place, that it is ineffective or that we need to do a lot more of it?

1. Nöthlings U, Boeing H, Maskarinec G, Sluik D, Teucher B, Kaaks R, Tjønneland A, Halkjaer J, Dethlefsen C, Overvad K, Amiano P, Toledo E, Bendinelli B, Grioni S, Tumino R, Sacerdote C, Mattiello A, Beulens JWJ, Iestra JA, Spijkerman AMW, van der A DL, Nilsson P, Sonestedt E, Rolandsson O, Franks PW, Vergnaud A-C, Romaguera D, Norat T, Kolonel LN. Food intake of individuals with and without diabetes across different countries and ethnic groups. Eur J Clin Nutr 2011 May;65(5):635-641. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21346715


  1. Thanks for alerting me to this study; as far as diabetes nutrition education in the UK goes, I believe the evidence shows that provision is patchy, especially for people who have had diabetes for a long time. The general guidance given, which is intended to be encouraging, can also be quite unhelpful: 'eat the same healthy diet that is recommended for everyone' can too easily be interpreted as 'eat the same as everyone else does', which is not at all what's meant. It's interesting that research is coming out about the effectiveness of slimming clubs; good ones provide long-term, weekly, detailed, personalised advice about food choices, as well as the motivation to make healthy choices, and it seems that this approach can change eating habits. Perhaps this approach is what it takes for people with diabetes to change their diets, but with the current model of diabetes education and constraints on NHS resources it is unlikely to happen.

  2. Found your blog via Cooksey's. Really appreciate that you are keeping an open minc. I agree with the above, because I have seen it. My husband is diabetic(type 2) and after being diagnosed, he followed the doctor's advice as best he could. A lot of diabetics (and non-diabetics included) think that sports drinks are not the same as soft drinks, so he allows himself that after cutting down on sweet things, salt, and fat. He did lose a bit of weight, over a few years. I saw him get depressed as his blood sugar wasn't really well controlled, neither was his hypertension, and the doc had just put him on statins. It seemed nothing was working. So he tried low carb. Over the past 3 months he has lost 20kgs, and about 10 inches on his waist. His blood sugar readings are close to normal. His HbA1c went down from 9.7 to 6.9 last month. He has less joint pains. His BP which was 150/90 (on meds) is now 120/70. But throughout it all he wished he had a doctor at least willing to go on this journey together. He is still taking his metformin, we are hoping when we next see his physician he can at least reduce the dose..